Abstract Recent epidemiological studies suggest that Fetal Alcohol Spectrum Disorder (FASD) may have a prevalence of up to 5% in the population (May, et al. 2014); however, it is rarely diagnosed in adulthood and there are no recognized treatment protocols because, despite decades of research on the effects of prenatal alcohol exposure (PAE), scientific study of adults with FASD is almost unknown. This lack of accurate information is devastating for these individuals, their families and a source of frustration for professionals who encounter affected individuals. Although neurodevelopmental deficits may be persistent, without accurate information about mental and physical health problems associated with PAE, caregivers, health care professionals and policy makers cannot make informed decisions, diagnose accurately, provide care or allocate resources. Supported by the resources provided by CIFASD, the current project is uniquely qualified to address this deficit and carry out the following Specific Aims: 1) Establish a registry of 500 individuals, older than 30 years of age, with known alcohol exposure/FASD diagnosis or who are matched controls who will respond to a health survey, and who will be available for future studies; 2) in affected individuals (FAS or FASD) and controls (120 from Atlanta and 120 from Seattle), to evaluate in depth current status in areas supporting adults physical and social functioning with the goal of refining diagnostic criteria for FASD in this age group and determining the persistence and severity of disability associated with PAE. This activity will include examination of dysmorphology, abstraction of medical records, substance use (self-report and biological samples), cognition and mental health as well as social factors that might contribute to outcomes and disability status. Finally, 3) to assess immune status (in collaboration with Dr. Weinberg) and identify outcomes associated with health indicators.